We Must Continue Our Legacy of Saving Lives

(Roll Call, March 7, 2013)

Now is no time to shy away from our health investments

By Bill Frist

A decade ago, as I was beginning my time as Senate majority leader, bipartisan consensus in Washington helped launch a new era of progress in global health just when it was sorely needed. Twenty years had passed since I first saw AIDS patients in Boston, though at the time we didn’t even have a name for this savage disease. Advances in treatment and technology were helping control HIV in the United States, but AIDS was decimating communities worldwide. There were tens of millions of infections, yet only 400,000 people in low- and middle-income countries had access to lifesaving antiretroviral therapy, meaning only a tiny fraction were able to escape death.

World leaders united to tackle AIDS and other scourges through an innovative financing tool — the Global Fund to Fight AIDS, Tuberculosis and Malaria. President George W. Bush and Congress made a founding pledge of $300 million to the international initiative. Bush, with bipartisan support from both chambers of Congress, also established the President’s Emergency Plan for AIDS Relief, the largest program ever to combat a single disease. President Barack Obama has similarly embraced this program and America’s role in eradicating this disease.

U.S. leadership at the Global Fund, and bilateral health programs such as PEPFAR and the President’s Malaria Initiative, signaled a renewed commitment to a core facet of our country’s greatness: compassion for those most in need. Understanding that improving global health is good for national security, economically prudent and — most importantly — the right thing to do, the U.S. taxpayers made an unprecedented investment in the world’s future.

That investment is paying off.

As we mark the 10th anniversary of PEPFAR this year, the number of people on lifesaving treatment has increased more than twentyfold. HIV infection rates are down. The number of malaria cases has plummeted by more than 50 percent. Tuberculosis mortality rates are falling steadily. The Global Fund alone saves an estimated 100,000 lives each and every month, working in more than 150 countries. These health gains were once unimaginable.

A new chapter in global health begins this month as visionary leader Dr. Mark Dybul takes the helm as executive director of the Global Fund. With so much gridlock in Washington, Dybul’s appointment is a reminder of what we can accomplish by reaching across party lines.

Dybul, who began as a physician treating AIDS patients in the early years of the pandemic, helped transform the fight against the disease as the architect and leader of PEPFAR. Now at the Global Fund, he will lead the charge to defeat AIDS, malaria and tuberculosis. Armed with scientific expertise and dedicated to a mission that goes beyond political ideology, there may be no one better suited for the job.

Today there is real hope in this fight — but it’s far from over. We have the science to help people with HIV live healthy lives, but millions still lack access to the treatment they need. We can detect and treat TB, but drug-resistant strains represent a growing threat, and disease respects no borders. And malaria still takes countless lives each year, though it can be stopped with basic, incredibly cheap prevention.

Now is no time to shy away from our health investments. Scientific innovation continues to produce miracles at an accelerating pace. International donors are stepping up to the plate. Many traditional aid recipients are putting more resources into their own domestic health. The U.S. investment — less than 1 percent of our federal budget — saves and transforms hundreds of thousands of lives every year. It’s hard to imagine a better return on investment.

U.S. leadership has helped deliver a major blow to these three diseases, and backing down now would jeopardize that momentum. We’ve come too far to risk letting these diseases spread, mutate or reclaim the lives of people whom medicines have made healthy. We must finish this fight.

There are also real problems here at home, not the least of which is a challenging economic environment. And there is frequent division in Washington. But while sweeping agreement on Capitol Hill may be rare, the same bipartisan, compassionate commitment to global health remains strong. Obama called PEPFAR one of his predecessor’s “greatest legacies.” As Dybul and the Global Fund chart the path forward, we see new U.S. leaders from both parties taking up the mantle of global health, united in putting an end to these diseases.

Determined leadership today will help secure a stronger America and a brighter, healthier future for millions in the years to come. We have a long way to go, but together we can finally put AIDS, tuberculosis and malaria where they belong — in the history books.

Bill Frist, a physician, is a former Republican senator and majority leader from Tennessee.

This article was originally featured in Roll Call http://www.rollcall.com/news/frist_we_must_continue_our_legacy_of_saving_lives-222946-1.html

Is AIDS the last bipartisan issue?

(The Week, July 31)

These days, Washington can’t agree on anything. Thankfully, though, some brave lawmakers are still willing to cross the aisle to fight a deadly disease.

We live in fiercely contentious times. Every day, it seems, a new issue arises that Democrats and Republicans cannot agree on. Health care, taxes, energy, favorite flavor of ice cream — it seems our elected leaders must disagree at every turn. But one issue that has so far repulsed the partisan pressures of the times was highlighted in our nation’s capital last week: the fight against HIV/AIDS.

Washington, D.C., hosted the XIX International AIDS Conference. It was an energetic, passion-filled week. More than 23,000 attendees from across the globe heard and engaged speakers including both former President Bill Clinton and Secretary of State Hillary Clinton, cutting edge research scientists, activists, Nobel laureates, world leaders, and even a few celebrities. Perhaps even more important, many HIV positive men and women came together from dozens of countries to find a caring, supportive community.

The United States — and more specifically, the American taxpayer — has been the undisputed world leader in fighting this cagey virus for which there is no cure. This single virus has taken the lives of more than 580,000 Americans and 25 million globally since it emerged here in our country just over 30 years ago. The conference was a celebration of the remarkable success made because of this leadership, and a call for continued support.

When we stop the hollowing out of societies and inspire hope, there is no limit to what we can accomplish together.

As moderator for a panel on the congressional role, I witnessed what I felt to be an accurate portrayal of how we got to the point where we could celebrate so many successes. Fundamental to the progress has been bipartisanship. Participating were two Democrats, Reps. Barbara Lee (Calif.) and Sen. Chris Coons (Del.), and two Republicans, Sens. Marco Rubio (Fla.) and Mike Enzi (Wyo.).

Our panel’s balanced party identification was more than symbolism, as Rep. Lee acknowledged when she described the U.S. response as bipartisan, saying, “it never would have happened without … Republicans in the House and the Senate.” Indeed, the bold $15 billion PEPFAR commitment initiated by President George W. Bush and supported by Congress was quickly taken up and expanded under the Obama administration. All panel members were quick to praise the leadership and dedication of the other’s party.

And there is cause for such praise. PEPFAR, unprecedented in scope and size in its combatting of a single disease, has saved millions of lives, provided 4.5 million people with treatment, enabled hundreds of thousands of HIV positive mothers to give birth to healthy, disease-free children, and allowed tens of millions to receive testing, counseling and care. In 1995, 50,000 Americans died of AIDS. In 2009, that number was down to 20,000. Promisingly, partner countries are increasingly supporting this work internally. Last year, poorer countries invested $8.6 billion into the fight as international financing provided by wealthier nations amounted to $8.2 billion. As I have said for years, when we stop the hollowing out of societies and inspire hope, there is no limit to what we can accomplish together.

The results of this bipartisan American commitment are in, and they are undeniable. Our past investment has inspired others to contribute, saved lives at home and around the world, and empowered economic development with a healthier workforce. But the risk today in a more highly charged partisan environment and in more fiscally challenging times is to say we have done our job and it’s time to move on. That would be a huge mistake, and all our progress would be erased because we still don’t have a cure. Around the world and at home, the AIDS epidemic is far from over.

Rep. Lee noted that there are still American communities where “the percentages [of AIDS] are comparable to sub-Saharan Africa.” This is unacceptable, and you do not have to look far into the past to a time when both parties wholeheartedly understood this.

As Sen. Enzi recollected, in 2003 the PEPFAR bill “passed both the House and Senate unanimously, un-amended, in less than two months. That never happens.” But Enzi elaborated that five years later, when the time came for reauthorization under President Bush, the measure passed “again in a bipartisan way” — although “we didn’t have quite the same votes that we had the first time.”

However, hope for preserving this flame of bipartisan conviction was articulately reflected by the two other members of the panel, Sens. Rubio and Coons, each representing different parties, and neither of whom were in office during the original PEPFAR passage. They have emerged as powerful and knowledgeable voices on global health and HIV. Such leadership is vital when the focus of Congress, today filled with new members who were not around when PEPFAR originally passed, is understandably on domestic issues, the economy, jobs, and health care.

While living and working in Africa in the mid 1980s, Sen. Coons was inspired by the profound human tragedy he witnessed firsthand and has transformed these experiences into true leadership. But he warns that we “can’t take [continued U.S. leadership] for granted in what is an incredibly difficult, very partisan and very divided Congress at a time when our politics are in some ways the rockiest they’ve been in more than a generation.” But out of a world of mudslinging and disagreement, the Democratic senator says it “has been really refreshing to be able to work closely with Republicans” to fight this epidemic.

At a time when our national debt is skyrocketing, the typical American finds it difficult to understand how massive spending for people overseas, even if it is lifesaving, can be justified. But just how massive is this spending really? Not the 25 percent of our budget that most Americans think. In truth, our foreign aid spending is less than 1 percent of the federal budget. As Sen. Rubio, himself a favorite of the Tea Party, eloquently asserted, “If you zeroed out foreign aid it would do nothing for the debt, but it would be devastating not just for the world, but for America’s role in it.”

Progress has been mind-blowing. Science made possible by taxpayer investment through the NIH has brought miraculous new drugs to treat and, just this month, new medicines to prevent. Cost of treatment has fallen ten-fold and continues to plummet. Prevention strategies have turned the tide of devastation. But all this was accomplished because Americans came together, Republican and Democrat, working hand in hand in a bipartisan and meaningful way, rallying together to fashion solutions that are changing the course of history.

As Sen. Rubio declared, “the closer we get to the finish line is not the time to ease up, it’s the time to run through the tape.” Let’s continue to put our partisan differences aside and run this one together.

Dr. William H. Frist is a nationally acclaimed heart transplant surgeon, former U.S. Senate Majority Leader, the chairman of Hope Through Healing Hands and Tennessee SCORE, professor of surgery, and author of six books. Learn more about his work at BillFrist.com.

This article was originally featured in The Week http://theweek.com/article/index/231271/is-aids-the-last-bipartisan-issue

Sen. Frist heads to Kenya to study famine’s effects

More than 29,000 young children have died of malnutrition and disease in Somalia in the past 90 days. We are now on our way to the Horn of Africa to see what more we as a nation can do.

Early this morning, our plane left Washington, D.C., bound for East Africa. I’m flying with Second Lady Dr. Jill Biden and USAID Administrator Raj Shah to study the famine’s effects on the lives of more than 12 million people, many of them children.

In fact, it is now being called “the children’s famine.”

Over the years, I have delivered medical care in refugee camps on a number of trips, both to camps in Darfur, in Chad (right on the border of Sudan), and in boy soldier camps in southern Sudan. I went as a doctor. Providing age-appropriate health care to the compromised and malnourished children and adults is crucial to combat rapidly spreading disease and death.

It begins with identifying the specific needs, which we will be doing, then ensuring access, which is a challenge especially in Somalia.

Aid agencies estimate that more than $1 billion more is needed during this critical period to stop further deaths and get proper food, water and health care especially to the children who are most vulnerable.

In the camps we visit, I will focus on the vaccinations given for measles, polio and malaria; oral rehydration distributed to those suffering from diarrhea; and vitamins for children to bolster their immune systems. These are simple, cheap interventions to fight disease in the malnourished. I am eager to learn what is being accomplished and what more needs to be done. America has done a lot which has lessened the unfolding tragedy in the region, but there is a lot more we can do to reverse the course underway.

We will learn much over the next few days. I am on this trip to hear the stories of the families and their journeys, and I will share those stories with you.

Please sign the ONE petition today to urge world leaders to provide the full funding that the UN has identified as necessary to help people in the Horn of Africa, and please keep your promises to deliver the long term solutions which could prevent crises like this from happening again.